CN103379934A - System and method for customizable automated control of fraction of inspired oxygen and/or positive end expiratory pressure to maintain oxygenation - Google Patents

System and method for customizable automated control of fraction of inspired oxygen and/or positive end expiratory pressure to maintain oxygenation Download PDF

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Publication number
CN103379934A
CN103379934A CN2011800678230A CN201180067823A CN103379934A CN 103379934 A CN103379934 A CN 103379934A CN 2011800678230 A CN2011800678230 A CN 2011800678230A CN 201180067823 A CN201180067823 A CN 201180067823A CN 103379934 A CN103379934 A CN 103379934A
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oxygen
content
therapeutic
module
experimenter
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CN103379934B (en
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S·加尔德
S·艾哈迈德
M·E·麦迪逊
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Koninklijke Philips NV
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Koninklijke Philips Electronics NV
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/0057—Pumps therefor
    • A61M16/0066—Blowers or centrifugal pumps
    • A61M16/0069—Blowers or centrifugal pumps the speed thereof being controlled by respiratory parameters, e.g. by inhalation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/0057—Pumps therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/021—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes operated by electrical means
    • A61M16/022—Control means therefor
    • A61M16/024—Control means therefor including calculation means, e.g. using a processor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/10—Preparation of respiratory gases or vapours
    • A61M16/105—Filters
    • A61M16/106—Filters in a path
    • A61M16/1065—Filters in a path in the expiratory path
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/10—Preparation of respiratory gases or vapours
    • A61M16/1005—Preparation of respiratory gases or vapours with O2 features or with parameter measurement
    • A61M2016/102—Measuring a parameter of the content of the delivered gas
    • A61M2016/1025—Measuring a parameter of the content of the delivered gas the O2 concentration
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2202/00—Special media to be introduced, removed or treated
    • A61M2202/02—Gases
    • A61M2202/0208—Oxygen
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/50—General characteristics of the apparatus with microprocessors or computers
    • A61M2205/502—User interfaces, e.g. screens or keyboards
    • A61M2205/505—Touch-screens; Virtual keyboard or keypads; Virtual buttons; Soft keys; Mouse touches
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2230/00—Measuring parameters of the user
    • A61M2230/20—Blood composition characteristics
    • A61M2230/205—Blood composition characteristics partial oxygen pressure (P-O2)

Abstract

A pressurized flow of breathable gas is delivered to the airway of a subject in accordance with a therapy regimen. The therapy regimen may be designed to maintain oxygenation of the subject. The therapy regimen dictates levels of fraction of inspired oxygen and/or positive end expiratory pressure to maintain a therapeutically beneficial level of oxygenation in a feedback manner. Within the therapy regimen, changes made to fraction of inspired oxygen and/or positive end expiratory pressure automatically and dynamically are constrained by user configured constraints such as the maximum incremental change, amount of time between adjustments, or the maximum rate of change This may provide a level of customization of the automated control of the therapy regime for individual subjects.

Description

Be used for customizable automatic control and suck the content of oxygen and/or end expiratory positive pressure to keep the system and method for Oxygenation
Technical field
The present invention relates to suck the content (fraction) of oxygen and/or the automatic control of end expiratory positive pressure, to keep experimenter's Oxygenation.
Background technology
Usually regulated the content of the suction oxygen that is delivered to the experimenter who accepts ventilation therapy by clinicist's (for example, providing special care to doctor, therapist, nurse etc.), change with the Oxygenation level to the experimenter and make response.The demand of regulating and the frequency of regulating the content that sucks oxygen are depended on experimenter's situation and whether the clinicist is arranged.In NICU, for premature infant, because spontaneous desaturation frequently, may be more common for the adjusting of the content that sucks oxygen.For other experimenters among the ICU, can regulate with the gradual change (improve or worsen) to experimenter's situation and make response.This demand to the adjusting of the contents level that sucks oxygen is usually brought very large workload to the clinicist.
Summary of the invention
An aspect of the present disclosure relates to the system that sucks the content of oxygen in a kind of pressurized stream of the breathable gas that is configured to control the lung that is delivered to the experimenter.In one embodiment, described system comprises pressure generator, user interface and one or more processor.Pressure generator is configured to generate the pressurized stream for the breathable gas of the lung that is delivered to the experimenter, and pressure generator is configured to control selectively by the oxygen concentration in the pressurized stream of regulating breathable gas the content of experimenter's suction oxygen.One or more processors are configured to the computer program module, and described computer program module comprises blood oxygen module, oxygen content module, interface module and control module.Blood oxygen module is configured to determine the Oxygenation metric levels of the amount of the oxygen that exists in the described experimenter's of expression the blood.The oxygen content module is configured to according to the definite content that sucks oxygen for described experimenter's therapeutic of therapeutic scheme, wherein, described oxygen content module is configured to determine dynamically that based on described Oxygenation tolerance described therapeutic sucks the content of oxygen with feedback system.Interface module is configured to receive the oxygen content constraint via user interface from the user.The oxygen content module also be configured to so that the oxygen content constraint that receives from the user via user interface therapeutic is sucked oxygen content dynamically determine retrain.Control module is configured to suck according to the therapeutic of being determined by described oxygen content module the content of oxygen and controls described pressure generator with the oxygen concentration in the pressurized stream of regulating breathable gas, with the content of control experimenter's suction oxygen.Described module can be arranged so that therapeutic scheme reduces in time therapeutic and sucks the content of oxygen and/or therapeutic end expiratory positive pressure so that the experimenter breaks away from dependence.
Another aspect of the present invention relates to the method that sucks the content of oxygen in the pressurized stream of breathable gas of lung that a kind of control is delivered to the experimenter.In one embodiment, the method comprises the pressurized stream that generates for the breathable gas of the lung that is delivered to the experimenter; The Oxygenation metric levels of the amount of the oxygen that exists in acquisition indication experimenter's the blood; Receive one or more oxygen content constraints via user interface from the user; The therapeutic that dynamically is identified for the experimenter based on Oxygenation tolerance according to therapeutic scheme with feedback system sucks the content of oxygen, wherein, the oxygen content constraint that receives from described user described therapeutic is sucked oxygen content dynamically determine retrain; And regulate oxygen concentration in the pressurized stream of described breathable gas according to the content that the therapeutic of dynamically determining sucks oxygen, with the content of the suction oxygen of controlling described experimenter.The method can comprise that reducing in time therapeutic sucks the content of oxygen and/or therapeutic end expiratory positive pressure so that the experimenter breaks away from dependence.
Another aspect of the present invention relates to a kind of system that sucks the content of oxygen for control for the pressurized stream of the breathable gas of the lung that is delivered to the experimenter.In one embodiment, this system comprises that generation is for the module of the pressurized stream of the breathable gas of the lung that is delivered to the experimenter; Be used for to obtain the module of Oxygenation metric levels of the amount of the oxygen that indication experimenter's blood exists; Receive the module of one or more oxygen content constraints from the user via user interface; The therapeutic that dynamically is identified for the experimenter according to therapeutic scheme with the amount of the oxygen that exists in the blood of feedback system based on the experimenter sucks the module of the content of oxygen, wherein, the oxygen content constraint that receives from described user described therapeutic is sucked oxygen content dynamically determine retrain; And the module of regulating the oxygen concentration in the pressurized stream of described breathable gas according to the content that the therapeutic of dynamically determining sucks oxygen, with the content of the suction oxygen of controlling described experimenter.This system can be configured to reduce in time therapeutic and suck the content of oxygen and/or therapeutic end expiratory positive pressure so that the experimenter breaks away from dependence.
Consider with reference to the accompanying drawings following the description and attached claim, these and other objects, features and characteristic of the present disclosure, and the operational approach of associated structural elements and function, and the economy of the combination of each several part and manufacturing, it is more apparent to become, institute's drawings attached all forms the part of this description, and wherein, similarly Reference numeral represents counterpart in each width of cloth figure.In one embodiment, the structure member shown in having drawn in proportion here.Yet should clearly understand, accompanying drawing is not restriction of the present invention just to illustration and description.In addition, will be appreciated that, also can with here shown in any embodiment or the architectural feature of describing be used for other embodiment.Yet should clearly understand, accompanying drawing is not to be intended to defining as limit just to illustration and description.As used in description and the claim, singulative " ", " one " and " being somebody's turn to do " comprise a plurality of indicants, unless linguistic context is clearly made other explanations.
Description of drawings
Fig. 1 illustrates the system that is configured to send to experimenter's lung according to therapeutic scheme the pressurized stream of breathable gas.
Fig. 2 illustrates the curve chart of partial pressure of oxygen in the oxygen saturation contrast arterial blood.
Fig. 3 illustrates the user interface that is configured to receive to system's control inputs, and this system is configured to send to experimenter's lung the pressurized stream of breathable gas.
Fig. 4 illustrates the method for the Oxygenation of keeping the experimenter.
The specific embodiment
Fig. 1 illustrates the system 10 that is configured to send to experimenter 12 lung according to therapeutic scheme the pressurized stream of breathable gas.Can design therapeutic scheme to keep experimenter 12 Oxygenation.Therapeutic scheme has been stipulated the content of suction oxygen and/or has been breathed the level of last malleation, to maintain the upper useful Oxygenation level for the treatment of by feedback system.System 10 be configured to to the content that sucks oxygen and/or breathe that last malleation causes automatically and dynamic change be subject to the restriction of user configured constraint.This can provide for individual subjects the customization of the certain level of therapeutic scheme.System 10 utilizes the measurement result of Oxygenation with the content of control suction oxygen with feedback system, described measurement result can be by user selection.Similarly, in keeping the process of Oxygenation, breathe the enforcement of the positive pressure-controlled in end and can be selected by user selection and/or cancellation.Therapeutic scheme can be configured to simply keep Oxygenation by the user, or can be by user's configuration so that experimenter 12 is provided by the treatment that is provided by system 10.In one embodiment, system 10 comprises the one or more and/or miscellaneous part in pressure generator 14, electronic memory 16, user interface 18, sensor 20, the processor 24.
In one embodiment, pressure generator 14 is configured to generate the pressurized stream for the breathable gas of the lung that is delivered to experimenter 12.For therapeutic purposes or for other purposes, pressure generator 14 can be controlled one or more parameters (for example, flow, pressure, volume, humidity, temperature, gas componant etc.) of the pressurized stream of breathable gas.Can be according to therapeutic scheme (for example, just as discussed below) control one or more parameters.Therapeutic scheme can be configured to carry out Oxygenation in experimenter's 12 bodies.As non-limiting example, pressure generator 14 can be configured to control the pressure of the pressurized stream of breathable gas, in order to keep therapeutic pressure of inspiration(Pi) and/or end expiratory positive pressure.Be the pressure of pressurized stream of management breathable gas, pressure generator 14 can comprise one or more parts, can control described one or more parts with the pressure of the pressurized stream of handling breathable gas.Such parts can comprise valve for example, blower fan, bellows, compressed gas source and/or be used for handling the miscellaneous part of pressure.Pressure generator 14 is configured to control oxygen concentration in the pressurized stream of breathable gas sucks oxygen to keep therapeutic content.Like this, pressure generator 14 is configured to the oxygen from source of oxygen 25 and another source of breathable gas (for example, surrounding air, wall source of the gas, canister and/or other sources) is mixed to regulate oxygen concentration in the pressurized stream of breathable gas.
Send the pressurized stream of breathable gas to experimenter 12 lung via experimenter's interface 26.Experimenter's interface 26 is configured to transmit to experimenter 12 lung the pressurized stream of the breathable gas that is generated by pressure generator 14.Like this, experimenter's interface 26 comprises pipeline 28 and interface utensil 30.The pressurized stream that pipeline is carried breathable gas to interface utensil 30, and interface utensil 30 is sent the pressurized stream of breathable gas to experimenter 12 lung.Some examples of interface utensil 30 can comprise, for example, endotracheal intubation, tracheal intubation, nasal cannula, nose cup, nose/mask, integrated mask or with experimenter's air flue and/or other interface utensils of lung transport gas stream.The invention is not restricted to these examples, and expected using any experimenter's interface to send the pressurized stream of breathable gas to experimenter 12.
Although experimenter's interface that the configuration of the illustrated system 10 of Fig. 1 has 26 is single, passive expiratory system, this is not intended to limit.Will be appreciated that the scope of the present disclosure comprises that experimenter's interface 26 is formed the embodiment of two subsystems, two subsystems comprise and are configured to receive the second pipe of exhaling from interface utensil 30.The second pipe that is connected to the ACTIVE CONTROL respiratory system can be carried such fluid to filter to the such fluid of airborne release, and/or carries such fluid to the miscellaneous part that comprises the parts within the system 10.
In one embodiment, electronic memory 16 comprises the electronic storage medium of storing information in the electronics mode.The electronic storage medium of electronic memory 16 can comprise with system 10 one to be provided (namely, substantially non-removable) system storage and/or one of removable memorizer or both, removable memorizer via port for example (for example, USB port, FireWire port port etc.) or driver (for example, disc driver etc.) can be connected to system 10 with removing.Electronic memory 16 (for example can comprise readable storage media, CDs etc.), the magnetic readable storage medium storing program for executing (for example, tape, magnetic hard drive, floppy disk etc.), based on the storage medium of electric charge (for example, EEPROM, RAM etc.), one or more and/or other electronically readable storage mediums in the solid storage medium (for example, flash drive etc.).The information that electronic memory 16 can store software algorithms, determined by processor 24, the information that receives via user interface 18 and/or the information that system 10 can be worked.Electronic memory 16 can be the individual components within (all or part of) system 10, perhaps electronic memory 16 can provide (all or part of) integratedly with one or more miscellaneous parts (for example, generator 14, user interface 18, processor 24 etc.) of system 10.
User interface 18 system 10 and one or more users (for example is configured to, experimenter 12, nursing staff, research worker, treatment policymaker etc.) between interface is provided, the user can provide information and from system's 10 reception information to system 10 by this interface.This is so that data, signal, result and/or instruction and any other can be linked up transmission between one or more that project (jointly being known as " information ") can be in user and pressure generator 14, electronic memory 16 and/or processor 24.The example that is suitable for being included in the interface arrangement in the user interface 18 comprises keypad, button, switch, keyboard, handle, lever, display screen, touch screen, speaker, mike, display lamp, acoustic alarm, printer, haptic feedback devices and/or other interface arrangements.In one embodiment, user interface 18 comprises the interface of a plurality of separation.In one embodiment, at least one interface that provides with generator 14 one is provided user interface 18.User interface 18 can be configured to receive from experimenter 12 the input user with modification system 10 can be selected to arrange.For example, user interface 18 can be configured to change pattern and the setting for the ventilation therapy of sending to experimenter 12.In another example, user interface 18 can be configured to system 10 maximum content and/or other parameters that sucks oxygen is set.
Should be understood that the present invention has expected that also with other communication technologys, hardwired or wireless technology are as user interface 18.For example, expected can be integrated with the removable memory interface that user interface 18 and electronic memory 16 provide in the present invention.In this example, can be from removable memorizer (for example, smart card, flash drive, removable disk etc.) to system 10 in load information so that the enforcement that the user can custom-built system 10.Be suitable for including, but not limited to RS-232 port, RF link, IR link, modem (phone, cable etc.) as user interface 18 with other exemplary input equipment and the technology that system 10 uses.In brief, the present invention expects any technology with system 10 communicate informations of being used for as user interface 18.
Sensor 20 comprises the sensor that is configured to generate the output signal of passing on the information relevant with the gas parameter of the pressurized stream of breathable gas, be configured to generate the sensor of the output signal of passing on the information relevant with experimenter 12 Oxygenation, and/or other sensors.Gas parameter can comprise, for example, flow, volume, pressure, composition (for example, one or more compositions, oxygen concentration for example), one or more in changing of humidity, temperature, acceleration, speed, parameters,acoustic, the indication parameter of breathing, and/or other gas parameters.In one embodiment, sensor 20 comprises flow transducer and pressure transducer.Sensor 20 can comprise this parameter of direct measurement one or more sensors (for example, by with pressure generator 14 place or experimenter's interface 26 in the pressurized stream fluid communication of breathable gas).Sensor 20 can comprise one or more sensors of the output signal that indirect generation is relevant with one or more fluid parameters of the pressurized stream of breathable gas.For example, one or more sensors 20 can generate output based on the operating parameter (for example, valve driver or motor current, voltage, rotary speed and/or other operating parameters) of pressure generator 14 and/or other sensors.
As mentioned above, sensor 20 can comprise and is configured to generate one or more sensors of passing on the output signal of experimenter 12 Oxygenation relevant information.The information relevant with Oxygenation can the indicating oxygen saturation, arterial partial pressure of oxygen, the partial pressure of carbon dioxide of arterial blood and/or other information relevant with Oxygenation.Such sensor can comprise the sensor that generates the output signal of reception and registration and Oxygenation relevant information in uninterrupted mode.For example, generating reception and registration can be by uninterrupted mode generating output signal with the sensor of the output signal of oxygen saturation relevant information.Some sensors may need more intrusive moods to measure (for example, extracting blood from experimenter 12).Such sensor can comprise the sensor of arterial partial pressure of oxygen, arterial blood oxygen partial pressure of carbon dioxide and/or other arterial blood measurement results.Can upgrade experimenter's 12 more invasive measurements (for example, arterial blood is measured) with periodicity (or basic cycle property) interval.For example, can carry out this measurement and be updated to system 10 with about 30 minutes interval and/or with other intervals.
Sensor 20 can comprise the sensor that is configured to the one or more transmission output signals in electronic memory 16, user interface 18 and/or the processor 24.For example, generate to pass on the sensor of the output signal of the information relevant with the gas parameter of the pressurized stream of breathable gas can be to the one or more transmission output signals in electronic memory 16, user interface 18 and/or the processor 24.Sensor 20 can comprise and is configured to the sensor that the device that separates with system 10 and/or be communicated with system 10 or equipment send output signal.For example, the sensor that generates the output signal of the reception and registration information relevant with oxygen saturation and/or arterial partial pressure of oxygen can be coupled with patient monitor 31, thereby the output signal of autobiography sensor sends to patient monitor 31 in the future.Patient monitor 31 can be configured to process output signal (for example, determining oxygen saturation and/or arterial partial pressure of oxygen).Patient monitor 31 can be coupled communicatedly with system 10, to send information, output signal and/or other information that derives from output signal to system 10.In another example, system 10 can be configured to so that the sensors coupled that generates the output signal relevant with oxygen saturation to system 10, and can be sent to output signal one or more in electronic memory 16, user interface 16 and/or the processor 24.Can realize such transmission via wired and/or wireless transmission.Sensor 20 can comprise need to be via user interface 18 artificial input measurement result's in the system 10 sensor.For example, the sensor of measurement arterial partial pressure of oxygen, arterial partial pressure of carbon dioxide and/or the measurement of other arterial bloods may need the 10 artificial measurement results of obtaining of inputting to system.
Processor 24 is configured to provide information processing capability in system 10.Like this, processor 24 can comprise digital processing unit, analog processor, be designed to the digital circuit of process information, the analog circuit that is designed to process information, state machine and/or be used for one or more of other mechanisms of electronics mode process information.Although processor 24 is illustrated as single entity in Fig. 1, this is only for exemplary purpose.In some embodiments, processor 24 can comprise a plurality of processing units.These processing units can be physically located in the same device (for example, pressure generator 14), and perhaps processor 24 can represent the processing capacity of a plurality of devices of co-ordination.For example, can provide at least some functions that are attributed to processor 24 here by the one or more processors that are associated with patient monitor 31.
As shown in Figure 1, processor 24 can be configured to carry out one or more computer program modules.Described one or more computer program module can comprise one or more and/or other modules in control module 32, respiration parameter module 34, oxygen saturation module 36, arterial oxygen module 38, partial pressure of oxygen module 40, PEEP module 42, expiration module 44, the interface module 46.Processor 24 can be configured to by software; Hardware; Firmware; Some combinations of software, hardware and/or firmware; And/or be used for other the machine-processed execution module 32,34,36,38,40,42,44 and/or 46 of configuration process ability on processor 24.
Will be appreciated that, be co-located within the single processing unit although in Fig. 1, module 32,34,36,38,40,42,44 and 46 is shown, comprise in the embodiment of a plurality of processing units at processor 24, in the module 32,34,36,38,40,42,44 and/or 46 one or more can with other modules away from.Hereinafter set forth by disparate modules 32,34,36,38,40,42,44 and/or 46 functional descriptions that provide only for the illustration purpose, the any module in the module 32,34,36,38,40,42,44 and/or 46 is not intended to limit, because can provide than described more or less function.For example, can remove one or more in the module 32,34,36,38,40,42,44 and/or 46 and can be by realize its some or repertoire except other modules in the module 32,34,36,38,40,42,44 and/or 46.As another example, processor 24 can be configured to carry out one or more extra modules, and additional modules can be carried out and hereinafter belong to module 32,34,36,38,40,42, some or all functions of one of 44 and/or 46.
Control module 32 is configured to controlled pressure generator 14, to regulate the parameter of the pressurized stream of breathable gas according to therapeutic scheme.Therapeutic scheme regulation will offer the pressurized stream of breathable gas of experimenter 12 lung, thereby the content that will suck oxygen maintains the content of therapeutic suction oxygen, and/or experimenter 12 end expiratory positive pressure is maintained end expiratory positive pressure.
For example, therapeutic scheme can be the non-invasive ventilation that comprises two horizontal stretchers.In such therapeutic scheme, the stress level of the pressurized stream of breathable gas is maintained at exhale level (being called EPAP or EPAP) during the expiration.In intake period, the stress level of the pressurized stream of raising breathable gas is to push gas in experimenter 12 lung.According to breathing rate and/or based on experimenter 12 spontaneous respiration effort triggering air-breathing Positive Airway Pressure (" IPAP ") and the variation between the EPAP.
Respiration parameter module 34 is configured to determine experimenter 12 respiration parameter.Respiration parameter module 34 is determined respiration parameter based on the output signal that sensor 20 generates.The respiration parameters that respiration parameter module 34 is determined can comprise tidal volume, breathing rate, minute ventilation, air-breathing resistance and compliance, respiratory muscle pressure and/or other respiration parameters and/or other respiration parameters with exhaling than, lung.
Oxygen saturation module 36 is configured to obtain experimenter 12 oxygen saturation.The oxygen saturation that obtains experimenter 12 may comprise determines that oxygen saturation and/or (for example, from patient monitor 31) receive determining of oxygen saturation.Determine oxygen saturation based on the output signal that sensor 20 generates.The oxygen saturation sensor is attached to the preferred site of patient body.Can pass through substantially continual mode (for example, sampling rate is lower than about 100 milliseconds) and determine, receive and/or otherwise obtain oxygen saturation.
Arterial oxygen module 38 is configured to determine experimenter 12 arterial partial pressure of oxygen.Arterial oxygen module 38 determines that arterial partial pressure of oxygen can be the estimations of substantially carrying out the arterial partial pressure of oxygen that middle mode carries out.This is because normally directly by extract the arterial partial pressure of oxygen of blood measuring from experimenter 12.In one embodiment, arterial oxygen module 38 is estimated arterial partial pressure of oxygen according to oxygen saturation.Usually, the oxygen saturation performance is related with arterial partial pressure of oxygen, thereby can estimate based on the oxygen saturation of measuring the arterial partial pressure of oxygen of given time.
As mentioned above, each time (for example, with periodic intervals), can obtain the arterial blood measurement result and be input to system 10.Such measurement result can comprise arterial partial pressure of oxygen, arterial partial pressure of carbon dioxide, pH value of blood and/or other measurement results.Determining of arterial partial pressure of oxygen calibrated or otherwise regulated to oxygen saturation when in one embodiment, arterial oxygen module 38 is configured to basis by system's 10 these measurement results of acquisition.
As illustration, Fig. 2 shows a few width of cloth figure of oxygen saturation and arterial partial pressure of oxygen.Can find out that in Fig. 2 the conversion between these two parameters is not linear.Like this, can use the measurement result calibration at intermittence of arterial partial pressure of oxygen and/or the conversion that adjusting oxygen saturation measurements result arrives the arterial partial pressure of oxygen estimated value.In addition, will be appreciated that from Fig. 2 that the relation between oxygen saturation and the arterial partial pressure of oxygen is subject to the impact of arterial partial pressure of carbon dioxide and/or pH value of blood.Therefore, can use the measurement result of arterial partial pressure of carbon dioxide and/or pH value of blood further to calibrate and/or regulate the conversion that the oxygen saturation measurements result arrives the arterial partial pressure of oxygen estimated value.
Return with reference to figure 1, oxygen content module 40 is configured to determine that therapeutic sucks the content of oxygen.The content of therapeutic suction oxygen is the content that just experimenter's 12 Oxygenation maintains the suction oxygen of the useful level for the treatment of.Control module 32 is configured to by controlled pressure generator 14 with oxygen concentration in the pressurized stream of regulating the breathable gas corresponding with the content of therapeutic suction oxygen, to realize being sucked by the therapeutic that oxygen content module 40 is determined the content of oxygen.
In one embodiment, determining that content that therapeutic sucks oxygen comprises determines that experimenter 12 oxygen saturation just maintains the content of the suction oxygen of the useful level for the treatment of.In one embodiment, oxygen content module 40 determines that therapeutic sucks the content of oxygen arterial partial pressure of oxygen is maintained the useful level for the treatment of.Oxygen content module 40 is configured to determine with feedback circuit the content of therapeutic suction oxygen, and feedback circuit uses other certain tolerance conduct of oxygen saturation, arterial partial pressure of oxygen and/or indication Oxygenation to input.If the measurement representation Oxygenation of using is too high, from the content of the downward adjustment for the treatment of suction of its present level oxygen.If the tolerance of using indication Oxygenation is excessively low, from the make progress content of adjustment for the treatment of suction oxygen of its present level.
Oxygen content module 40 is configured to so that the adjusting that therapeutic is sucked the content of oxygen is subject to the constraint of oxygen content constraint.Oxygen content constraint (for example can retrain content that therapeutic sucks oxygen, on time slip-window) rate of change, therapeutic suck in the time adjacency of adjusting of the increment of adjustment of the content of oxygen, top level that therapeutic sucks the content of oxygen, floor level that therapeutic sucks the content of oxygen, content that therapeutic sucks oxygen one or more, and/or can otherwise retrain therapeutic is sucked the adjusting that the content of oxygen is determined.The oxygen content constraint of the rate of change of the content of constraint therapeutic suction oxygen can arrange the flank speed of variation.The oxygen content constraint of the increment of adjustment of the content of constraint therapeutic suction oxygen can arrange the amount of standard increment, and the amount of Minimum Increment can be set, and the amount of maximal increment can be set, and/or can retrain by other means increment of adjustment.The oxygen content constraint of adjusting adjacency that the constraint therapeutic sucks the content of oxygen can arrange in the past Primary regulation to the minimum waiting time that can regulate next time, and/or can suck by otherwise retraining therapeutic the time adjacency of the content adjusting of oxygen.
In one embodiment, oxygen content module 40 is configured to only determine that therapeutic sucks the content (or doing substantially like this) of oxygen, to keep the Oxygenation in experimenter's 12 bodies.In one embodiment, oxygen content module 40 is configured to along with time system ground reduces the content that therapeutic sucks oxygen.The systematicness of carrying out the content of therapeutic suction oxygen reduces, so that experimenter 12 breaks away from the excess oxygen that comprises in the pressurized stream of breathable gas gradually.
PEEP module 42 is configured to determine the therapeutic end expiratory positive pressure.The therapeutic end expiratory positive pressure is the end expiratory positive pressure that helps the Oxygenation in experimenter's 12 blood is maintained the useful level for the treatment of.In one embodiment, determine that the therapeutic end expiratory positive pressure comprises the end expiratory positive pressure of determining to help experimenter 12 Oxygenation is maintained the useful level for the treatment of.In one embodiment, PEEP module 42 determines that the therapeutic end expiratory positive pressure is to maintain arterial partial pressure of oxygen the useful level for the treatment of.PEEP module 42 is configured to definite therapeutic end expiratory positive pressure in feedback circuit, and this feedback circuit uses other certain tolerance conduct of oxygen saturation, arterial partial pressure of oxygen and/or indication Oxygenation to input.If the tolerance of using indication Oxygenation is too high, from the downward adjustment for the treatment of end expiratory positive pressure of its present level.If the tolerance of using indication Oxygenation is excessively low, from its present level adjustment for the treatment of end expiratory positive pressure that makes progress.
PEEP module 42 is configured to so that the adjusting of therapeutic end expiratory positive pressure is subject to the constraint of PEEP constraint.End expiratory positive pressure (for example can retrain the therapeutic end expiratory positive pressure, on time slip-window) the floor level, time adjacency that the therapeutic end expiratory positive pressure is regulated of top level, therapeutic end expiratory positive pressure of increment of adjustment, therapeutic end expiratory positive pressure of rate of change, therapeutic end expiratory positive pressure in one or more, and/or can retrain by other means determining the adjusting of therapeutic end expiratory positive pressure.The PEEP constraint of the rate of change of constraint therapeutic end expiratory positive pressure can arrange the flank speed of variation.The PEEP constraint of the increment of adjustment of constraint therapeutic end expiratory positive pressure can arrange the amount of standard increment, and the amount of Minimum Increment can be set, and the amount of maximal increment can be set, and/or can retrain by other means increment of adjustment.The PEEP constraint of the adjusting time adjacency of constraint therapeutic end expiratory positive pressure can arrange the past Primary regulation to the minimum waiting time that can regulate next time, and/or the time adjacency that can regulate by otherwise retraining the therapeutic end expiratory positive pressure.
In one embodiment, PEEP module 42 is configured to only determine therapeutic end expiratory positive pressure (perhaps doing substantially like this), to keep the Oxygenation in experimenter's 12 bodies.In one embodiment, PEEP module 42 is configured in time that beetle haulage system ground reduces the therapeutic end expiratory positive pressure.The systematicness of carrying out the therapeutic end expiratory positive pressure reduces, and sends so that experimenter 12 breaks away from the gas pressurized of the pressurized stream realization of breathable gas gradually.
Expiration module 44 is configured to determine the breath pressure level corresponding with the therapeutic end expiratory positive pressure.Can utilize end expiratory positive pressure that respiration parameter module 34 determines as input, determine this value with feedback system.When the therapeutic end expiratory positive pressure being made adjusting, can make corresponding the adjusting to the breath pressure levels that expiration module 44 is determined.Control module 32 realizes the breath pressure level that expiration module 44 is determined, so that the pressurized stream of breathable gas to be provided to the experimenter with the breath pressure level during exhaling.Experimenter 12 end expiratory positive pressure can be maintained the therapeutic end expiratory positive pressure like this.
Interface module 46 is configured to receive from the user via user interface 18 selection and/or the input of control inputs.Control inputs can predetermined operation system 10 one or more aspects.As non-limiting example, control inputs can define oxygen content constraint, PEEP constraint, be used for determining that therapeutic sucks the one or more of the warning setting of the content of oxygen and/or the Oxygenation tolerance of therapeutic end expiratory positive pressure, activation and the deactivation, the activation of breaking away from operator scheme or the deactivation that are used for the operator scheme of end expiratory positive pressure control, the content that is used for low oxygen saturation and high or the highest suction oxygen and high or the highest PEEP level and the limit, and/or other factors in system's 10 operations.
As illustration, Fig. 3 illustrates graphic user interface 48, can generate described graphic user interface to receive selection and/or the input of control inputs from the user.Can be via shown in Figure 1 and mentioned above with user interface 18() same or analogous user interface presents graphic user interface 48 to the user.Graphic user interface 48 can comprise Oxygenation tolerance district 50, oxygen content confining region 52, break away from pattern district 54, PEEP confining region 56, the definite district 58 of Oxygenation and/or other districts.
Oxygenation tolerance district 50 is configured to receive selection and/or the input of the control inputs relevant with the Oxygenation tolerance of implementing with feedback system, to determine therapeutic is sucked the adjusting of the content of oxygen.Control inputs can comprise metric sebection, minimum Oxygenation level, therapeutic Oxygenation level and/or other control inputs.Metric sebection specifies the Oxygenation that will implement to measure to determine therapeutic is sucked the adjusting of the content of oxygen.Oxygenation tolerance district 50 can be configured to receive selection and/or the input of oxygen saturation, arterial partial pressure of oxygen and/or other tolerance that will realize.Minimum Oxygenation level can be provided for the floor level of selected Oxygenation tolerance.The content that therapeutic Oxygenation level can arrange adjustment for the treatment of suction oxygen is with the level of the selected Oxygenation tolerance kept.
Oxygen content confining region 52 is configured to receive selection and/or the input of control inputs, oxygen content constraint and/or other control inputs relevant with the content of therapeutic suction oxygen.What the oxygen content constraint that receives by oxygen content confining region 52 can comprise that constraint rate of change, increment constraint are regulated, top level constraint, floor level constraint, waiting time constraint and/or other oxygen contents are intrafascicular approximately is one or more.
Breaking away from pattern district 54 is configured to receive and breaks away from mode activation/deactivate, break away from the waiting time, breaks away from selection and/or the input of regulating constraint and/or other control inputs.Breaking away from the waiting time can be defined in and reduce therapeutic and how long suck between the content of oxygen and/or the therapeutic end expiratory positive pressure cost.Break away from and regulate constraint and can be defined in and be used for reducing therapeutic during breaking away from and suck the content of oxygen and/or the increment of adjustment of therapeutic end expiratory positive pressure.
PEEP confining region 56 is configured to receive selection and/or input, PEEP constraint and/or other control inputs of the activation of PEEP pattern/deactivation, the control inputs relevant with the therapeutic end expiratory positive pressure.The activation of PEEP pattern/deactivation activates and/or deactivates dynamically determining of therapeutic end expiratory positive pressure selectively based on Oxygenation.If deactivation PEEP pattern can be set to the therapeutic end expiratory positive pressure so fixing horizontal and/or determined based on other inputs.What the PEEP constraint that receives by PEEP confining region 56 can comprise that constraint rate of change, increment constraint are regulated, top level constraint, floor level constraint, waiting time constraint and/or other PEEP are intrafascicular approximately is one or more.
Oxygenation determines that district 58 is configured to receive the control inputs of specifying the moment of determining Oxygenation tolerance.These control inputs can comprise meansigma methods sampling period, Oxygenation trend sampling period and/or other control inputs.
Fig. 4 illustrates the method 60 of the Oxygenation of keeping the experimenter.The work of the method 60 that provides is intended to carry out illustration.In certain embodiments, can utilize not one or more operation bidirectionals of describing and/or need not described one or more operations come Method Of Accomplishment 60.In addition, the order of illustration and the hereinafter operation of describing method 60 is not intended to limit among Fig. 4.
In certain embodiments, can be in some or all operations of implementation method 60 in one or more blood processor (for example, digital processing unit, analog processor, the digital circuit that is designed to process information, the analog circuit that is designed to process information, state machine and/or other mechanisms with electronics mode process information).One or more blood processor can comprise in response to the one or more devices that are stored in some or all operations of the instruction executing method 60 on the electronic storage medium in the electronics mode.One or more blood processor can comprise by hardware, firmware and/or software arrangements, with one or more devices of one or more operations of being specifically designed to manner of execution 60.
In operation 62, receive one or more control inputs from the user.One or more aspects of the treatment that control inputs regulation, impact and/or definition will be received by the experimenter.Control inputs can comprise therapeutic Oxygenation level, Oxygenation metric sebection, the maximum contents level that sucks oxygen, minimum contents level, PEEP constraint, the PEEP mode activation/deactivate that sucks oxygen, break away from one or more in mode activation/deactivation, and/or other control inputs.In one embodiment, by shown in Figure 1 and mentioned above with interface module 46() similar or identical interface module executable operations 62, its via with user interface 18 and/or graphic user interface 48(respectively Fig. 1 with shown in 3 and as mentioned above) similar or identical user interface receives one or more control inputs.
In operation 64, generate the pressurized stream of breathable gas to be delivered to experimenter's lung.Can control according to therapeutic scheme one or more parameters of the pressurized stream of breathable gas.In one embodiment, by the pressure generator similar or identical with (shown in Figure 1 and mentioned above) pressure generator 14, executable operations 64 under the control module control similar or identical with (shown in Figure 1 and mentioned above) control module 32.
In operation 66, obtain Oxygenation tolerance, the amount of the oxygen that exists in its indication experimenter's the blood.Oxygenation tolerance can comprise oxygen saturation, arterial partial pressure of oxygen and/or other Oxygenations tolerance.Estimate Oxygenation tolerance definite can the comprising of Oxygenation tolerance.Can by what receive at operation 62 places, indicate the control inputs of concrete Oxygenation tolerance to be defined in the Oxygenation tolerance that operation 66 places obtain.Obtaining Oxygenation tolerance (for example can comprise, based on sensor output signal) determine Oxygenation tolerance, and/or receive determining of Oxygenation tolerance from external component (for example, from the patient monitor similar or identical with patient monitor shown in Figure 1 with mentioned above 31).In one embodiment, can be by similar or identical with (shown in Figure 1 and mentioned above) oxygen saturation module 36 and/or arterial oxygen module 38 respectively oxygen saturation module and/or arterial oxygen module executable operations 66.
In operation 68, determine whether to calibrate and/or to regulate determining of Oxygenation tolerance.Can calibrate and/or regulate in response to the input of the measurement result of the Oxygenation tolerance of only intermittently obtaining and/or when receiving.Can measure off and on, because it is invasive for the experimenter.In response to being suitable for calibrating and/or regulating at operation 68 places, method 60 proceeds to operation 70.
In operation 70, what calibration and/or adjusting Oxygenation were measured determines.Determine it can is to estimate the arterial partial pressure of oxygen definite according to oxygen saturation through what calibrate/regulate, as described herein.In one embodiment, by with (shown in Figure 1 and mentioned above) arterial oxygen module 38 same or analogous arterial oxygen module executable operations 70.
From operating 68 or from operating 70, method 60 proceeds to operation 72 and operation 74.In operation 72, the Oxygenation tolerance based on determining at operation 66 places determines whether to determine the therapeutic end expiratory positive pressure.Can be activated or deactivate based on the PEEP pattern and determine this situation.Can be by activation or the deactivation of the control inputs regulation PEEP pattern that operates the reception of 62 places.In response to determining to determine the therapeutic end expiratory positive pressure that based on Oxygenation tolerance method 60 proceeds to operation 76.In response to determining should not determine the therapeutic end expiratory positive pressure that based on Oxygenation tolerance method 60 proceeds to operation 74.
In operation 74, determine that based on the Oxygenation tolerance of determining at operation 66 places therapeutic sucks the content of oxygen.Determine that therapeutic sucks the content of oxygen Oxygenation tolerance is maintained (for example, receiving at operation 62 places) therapeutic level.In response to a part of breaking away from mode activation at the suction oxygen of operation 62 receptions, the therapeutic of can successively decreasing sucks the content of oxygen, to attempt to make the treatment that the experimenter breaks away to be provided by method 60.If need to suck from its previous horizontal adjustment therapeutic the content of oxygen, by retraining this adjusting in operation 62 from the oxygen content that the user receives.In one embodiment, by with (shown in Figure 1 and mentioned above) oxygen content module 40 same or analogous oxygen content module executable operations 74.
In operation 76, determine the therapeutic end expiratory positive pressure based on the Oxygenation tolerance of determining at operation 66 places.Determine that the therapeutic end expiratory positive pressure is to maintain Oxygenation tolerance (for example, receiving at operation 62 places) therapeutic level.In response to a part of breaking away from mode activation at the PEEP that operate 62 receptions, the therapeutic of can successively decreasing end expiratory positive pressure is to scheme to make the treatment that the experimenter breaks away to be provided by method 60.If need to be from its previous horizontal adjustment therapeutic end expiratory positive pressure, by retraining this adjusting in operation 62 from the PEEP that the user receives.In one embodiment, by the PEEP module executable operations 76 similar or identical with (shown in Figure 1 and mentioned above) PEEP module 42.
In operation 78, suck the content of oxygen and/or the pressurized stream of regulating breathable gas in the therapeutic end expiratory positive pressure that operation 76 is determined based on the therapeutic of determining in operation 74.In one embodiment, by the pressure generator similar or identical with (shown in Figure 1 and mentioned above) pressure generator 14, executable operations 78 under the control module control similar or identical with (shown in Figure 1 and mentioned above) control module 32.
Think that based on current most realistic and preferred embodiment describes the present invention in detail at this for illustrative purposes, but be appreciated that, such details only is for this purpose, this explanation is not limited to disclosed embodiment, but opposite, be intended to be encompassed in modification and equivalent arrangement within the spirit and scope of claims.For example, be appreciated that the disclosure considers within the bounds of possibility, can be with one or more features of any embodiment and one or more characteristics combination of any other embodiment.

Claims (15)

1. suck the system of the content of oxygen in the pressurized stream of a breathable gas that is configured to control the lung that is delivered to the experimenter, described system comprises:
Pressure generator (14), it is configured to generate the pressurized stream for the breathable gas of the lung that is delivered to described experimenter, and described pressure generator is configured to control selectively by oxygen concentration in the pressurized stream of regulating described breathable gas the content of described experimenter's described suction oxygen;
User interface (18,48);
One or more processors (24), it is configured to the computer program module, and described computer program module comprises:
Blood oxygen module (36,38), it is configured to determine the Oxygenation metric levels of the amount of the oxygen that exists in the described experimenter's of expression the blood;
Oxygen content module (40), it is configured to according to the definite content that sucks oxygen for described experimenter's therapeutic of therapeutic scheme, wherein, described oxygen content module is configured to determine dynamically that based on described Oxygenation tolerance described therapeutic sucks the content of oxygen with feedback system;
Interface module (46), it is configured to receive the oxygen content constraint via described user interface from the user, wherein, described oxygen content module also be configured to so that the described oxygen content constraint that receives from described user via described user interface described therapeutic is sucked oxygen content dynamically determine retrain; And
Control module (32), it is configured to control described pressure generator according to the content of the therapeutic suction oxygen of being determined by described oxygen content module, with the oxygen concentration in the pressurized stream of regulating described breathable gas, thereby control the content of described experimenter's described suction oxygen.
2. system according to claim 1, wherein, described interface module is configured to so that the constraint of described oxygen content comprises as lower one or more: as described in therapeutic suck the amplitude peak of incremental variations of the content of oxygen; Time quantum between the adjusting of the content of described therapeutic suction oxygen; Perhaps described therapeutic sucks the amplitude peak of rate of change of the content of oxygen.
3. system according to claim 1, wherein, blood oxygen module is configured to so that described Oxygenation tolerance is oxygen saturation or arterial partial pressure of oxygen.
4. system according to claim 1, wherein, described computer program module also comprises:
PEEP module (42), it is configured to determine the therapeutic end expiratory positive pressure; And
Expiration module (44), it is configured to determine the breath pressure for the pressurized stream of described breathable gas, described breath pressure maintains described therapeutic end expiratory positive pressure with described experimenter's described end expiratory positive pressure,
Wherein, described control module also is configured to during exhaling to provide the described breath pressure of being determined by described expiration module for the pressurized stream of described breathable gas, thereby keeps described therapeutic end expiratory positive pressure.
5. system according to claim 4, wherein, described PEEP module is configured to dynamically determine described therapeutic end expiratory positive pressure based on described Oxygenation metric levels according to described therapeutic scheme with feedback system.
6. a control is delivered to the method that sucks the content of oxygen in experimenter's the pressurized stream of breathable gas of lung, and described method comprises:
Generate (64) for the pressurized stream of the breathable gas of the lung that is delivered to the experimenter;
Obtain (66) and indicate the Oxygenation metric levels of the amount of the oxygen that exists in described experimenter's the blood;
Receive (62) one or more oxygen content constraints via user interface from the user;
Determine dynamically that according to therapeutic scheme (74) suck the content of oxygen for described experimenter's therapeutic based on Oxygenation tolerance with feedback system, wherein, the oxygen content constraint that receives from described user described therapeutic is sucked oxygen content dynamically determine retrain; And
The content that sucks oxygen according to the therapeutic of dynamically determining is regulated the oxygen concentration in the pressurized stream of (78) described breathable gas, with the content of the suction oxygen of controlling described experimenter.
7. method according to claim 6, wherein, the constraint of described oxygen content comprises that described therapeutic sucks one or more in the amplitude peak of rate of change of the content that time quantum between the adjusting of amplitude peak, content that described therapeutic sucks oxygen of incremental variations of content of oxygen or described therapeutic suck oxygen.
8. method according to claim 6, wherein, described Oxygenation tolerance is oxygen saturation or arterial partial pressure of oxygen.
9. method according to claim 6 also comprises:
Dynamically determine (76) therapeutic end expiratory positive pressure;
Dynamically determine (78) for the breath pressure of the pressurized stream of described breathable gas, described breath pressure maintains described therapeutic end expiratory positive pressure with described experimenter's described end expiratory positive pressure; And
Pressurized stream for described breathable gas during exhaling provides (64) for keeping the definite described breath pressure of described therapeutic end expiratory positive pressure.
10. method according to claim 9 wherein, determines that dynamically described therapeutic end expiratory positive pressure comprises: determine described therapeutic end expiratory positive pressure based on described Oxygenation metric levels according to described therapeutic scheme with feedback system.
11. the system for the content of the pressurized stream suction oxygen of the breathable gas of controlling the lung that is delivered to the experimenter, described system comprises:
Be used for generation for the module (14) of the pressurized stream of the breathable gas of the lung that is delivered to described experimenter;
Be used for to obtain the module (36,38) of Oxygenation metric levels of the amount of the oxygen that the described experimenter's of indication blood exists;
Be used for receiving from the user via user interface the module (46) of one or more oxygen content constraints;
The amount that is used for the oxygen that exists based on described experimenter's blood with feedback system dynamically determines to suck for described experimenter's therapeutic the module (40) of the content of oxygen according to therapeutic scheme, wherein, the described oxygen content constraint that receives from described user described therapeutic is sucked oxygen content dynamically determine retrain; And
Be used for regulating the oxygen concentration of pressurized stream of described breathable gas with the module (14) of the content of the suction oxygen of controlling described experimenter according to the content that the described therapeutic of dynamically determining sucks oxygen.
12. system according to claim 11, wherein, the constraint of described oxygen content comprises as lower one or more: as described in therapeutic suck the amplitude peak of incremental variations of the content of oxygen; Time quantum between the adjusting of the content of described therapeutic suction oxygen; Perhaps described therapeutic sucks the amplitude peak of rate of change of the content of oxygen.
13. system according to claim 11, wherein, the module that is used for obtaining the amount of the oxygen that described experimenter's blood exists is configured to determine oxygen saturation and/or definite arterial partial pressure of oxygen.
14. system according to claim 11 also comprises:
Be used for dynamically determining the module (42) of therapeutic end expiratory positive pressure;
Be used for dynamically determining that described breath pressure maintains described therapeutic end expiratory positive pressure with experimenter's described end expiratory positive pressure for the module (44) of the breath pressure of the pressurized stream of described breathable gas; And
Be provided as the module (14) of keeping the definite described breath pressure of described therapeutic end expiratory positive pressure for the pressurized stream for described breathable gas during exhaling.
15. system according to claim 14, wherein, the module that is used for dynamically determining described therapeutic end expiratory positive pressure is configured to the amount of the oxygen that exists based on described experimenter's blood with feedback system and determines described therapeutic end expiratory positive pressure according to described therapeutic scheme.
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EP2651478B1 (en) 2017-09-06
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US9937308B2 (en) 2018-04-10
US20130312754A1 (en) 2013-11-28

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